'Overstretched' neurology department following under-experienced managers

Jersey's neurological department is overstretched, with 'dedicated' staff following inexperienced managers, a review has found.

The Royal College of Physicians has examined the service.

It heard that it was not always easy to raise concerns and issues directly with the neurology team.

Interviewees mentioned that they sometimes 'felt pressured to follow unsafe practices' by managers who had 'limited experience in the hospital environment' and did not 'fully grasp the potential consequences.'

When concerns were raised, they reported that these were often ignored by managers. 

However, Simon West, Medical Director for Health and Care Jersey, says he 'very pleased' with the review, and these are  'obviously' the opinions of individual members of staff:

"We've highlighted this; this is a very specific personal view. 

"Members of staff also commented that the managers were supportive, so there's a dichotomy there, and these are individual views."

The review found that the department was 'strongly committed', but faces 'workload pressures' that are 'challenging and unmanageable at times.'

Mr West told Channel 103 that the number of patients has more than doubled in four years. 

Many staff reported that they felt overstretched as demand for services increases.

Mr West said some people are working 'above and beyond', doing more hours than they 'perhaps would have expected to'  because of the volume of work, which is 'indicative' of the need to expand the workforce.

Delays were found in accessing tests, which - at times  - delayed diagnosis and treatments.

The review team also heard of instances where incorrect prescriptions were received by pharmacies.

The Sophie Reid Neurological Association says that the review confirms 'something that neurological patients have been experiencing for a long time:'

"The island currently relies on many different UK providers for specialist treatment, with care often arranged case-by-case rather than through a defined pathway.

The strategy now moving forward is to create clearer partnerships and coordinated referral systems.

For neurological conditions, particularly brain tumours, continuity of care is not a luxury, it is part of treatment.

Diagnosis, surgery, oncology, rehabilitation, seizure management and monitoring all depend on one connected clinical team.

A Neuro-Oncology Pathway would not create a new service in Jersey, it would apply the structure already planned within the healthcare strategy to one of the most complex conditions patients face.

The Association welcomes the move toward coordinated care and hopes to support the development of a defined pathway so that no patient has to navigate multiple providers without clear clinical ownership again.”

All interviewees spoke highly of the consultant leading the neurology service, noting his support, enthusiasm, and improvements he had made. The review team noted that an opportunity for 'strategic planning' was missed ahead of his departure.

There was a 'strong commitment' from all those involved with the service and its management, including the ministerial team, to improving neurology patient care.

The review concluded there are positive foundations to support a new model for the service and its growing demand, with a dedicated team.

The RCP team agreed with interviewees that the structure needed to be changed, and that it 'could not be maintained with a single consultant'.

The review looked at 12 clinical records, made up of four randomly-selected cases of diagnoses of epilepsy, Parkinson's, and multiple sclerosis.

It also interviewed those working in the neurology service, including other relevant staff from the healthcare organisation, and reviewed neurology service documents.

The report makes 20 recommendations including appointing a second neurology consultant.  

It also recommends upskilling the nursing workforce. 

An action plan has been devised from the findings, and Mr West says they want to cover the recommendations within the year:

"We've been ambitious, but recognise that where some of them are more difficult, we may need to take longer."

A further recruitment round for a Consultant Neurologist, after the first did not secure a suitable replacement, is underway, with interviews scheduled for March 2026.

The Minister for Health and Social Services, Deputy Tom Binet, said:

“I was pleased to see that the review highlighted a strong commitment across the neurology team, senior management, as well as the Ministerial team to improve services and that it also found that there were solid foundations in place to support patient outcomes.

“Following the recommendations outlined in the review, an action plan has been drawn up, and two of the actions have already been completed.

"Work continues to enhance the service, and I’d like to thank the team who work in this complex speciality for their continued dedication and commitment to patients.”